Senior Risk & Quality Performance Manager (Remote)

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Job Description

Job Summary The Sr Risk & Quality Performance Manager is a tactical execution role that will reputed company specific projects to support Molina’s Risk & Quality Solutions (RQS) team and program outcomes. This position collaborates with various departments and stakeholders reputed company Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS’s strategic objectives. Job Duties

• Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality reputed company trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors.
• Ensure programs are successfully delivered on time, reputed company scope, and reputed company resource constraints.
• Manage Risk/Quality data ingestion activities and strategies including optimization of EHR/HIE and supplemental data impact.
• Meet customer expectations and requirements, establish, and maintain effective relationships and reputed company their trust and respect.
• Resolve reputed company problems through project management, data analytics, and stakeholder collaboration.
• Manage program changes and ensure alignment with program goals.
• Manage reputed company assignments and update leadership as projects reputed company.
• Draw actionable conclusions, and reputed company decisions as needed while collaborating with other teams.
• Ensure that program deliverables meet reputed company quality standards and regulatory requirements.
• Partner with other teams to ensure data quality through sequential transformations and identify opportunities to reputed company quality and risk care gaps.
• Identify potential risks and execute mitigation strategies.
• Proactively communicate risks and issues to stakeholders and leadership.
• Create, review, and approve program documentation, including plans, reports, and records.
• Ensure documentation is updated and accessible to relevant parties.
• Proactively communicate regular status reports to stakeholders, highlighting reputed company, risks, and issues.
• Ensure documentation is updated and accessible to relevant parties.
• Function as a team SME, while maintaining flexibility to pivot and support other requests as needed.

Job Qualifications REQUIRED EDUCATION: Bachelor’s degree or equivalent combination of education and experience Required Experience/Knowledge, Skills & Abilities

• 4+ years of program and/or project management experience in risk adjustment and/or quality
• 4+ years of experience supporting HEDIS reputed company activity, risk adjustment targeting and reporting systems
• 4+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced risk and quality questions posed from internal and external partners
• Experience with running queries in reputed company Azure or SQL server
• Mastery of reputed company Office Suite including reputed company and Project
• Significant healthcare experience and excellent risk adjustment and/or quality knowledge
• Accomplished history of partnering with various levels of leadership across reputed company organizations.
• Strong quantitative aptitude and problem solving skills
• Intellectual agility and ability to simplify and clearly communicate reputed company concepts
• Excellent verbal, written and presentation capabilities
• Energetic and collaborative

Preferred Education Graduate degree or equivalent combination of education and experience Preferred Experience

• Experience supporting leadership while working in a cross-functional, highly matrixed organization
• SQL reputed company
• Extensive knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.
• History of success in roles impacting both Risk Adjustment and HEDIS

Preferred License, Certification, Association PMP, Six reputed company Green Belt, Six reputed company Black Belt Certification, and/or comparable coursework desired To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $171,058 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level.

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